■ Postmenopausal women taking antidepressants face an increased risk for stroke and death compared with those not using these medications.

Cholesterol levels increase sharply at the onset of menopause, which may elevate the risk of coronary heart disease, according to a study in the Dec. 15/22, 2009, Journal of the American College of Cardiology (link).

The study indicated that early intervention by physicians could reduce this risk.

Researchers analyzed data from 1,054 women who participated in the Study of Women's Health Across the Nation. SWAN is a multisite, epidemiologic study, funded by the National Institutes of Health, that has followed more than 3,000 middle-age American women since 1996.

The study indicated that regardless of women's ethnicity, the levels of total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B were significantly greater around the year of the final menstrual period than levels before and after that time.

Author Karen A. Matthews, PhD, suggested that physicians order a lipid panel for their patients nearing menopause. If a woman's levels are high, she recommended that physicians request the test annually and suggest lifestyle changes to help prevent coronary heart disease.

"The first line of change is always lifestyle, because medication can be expensive, and all medications have some side effects," said Matthews, professor of epidemiology and psychology at the University of Pittsburgh School of Medicine.

Postmenopausal women who take antidepressants have an increased risk of mortality, according to another study in the Dec. 14/28, 2009, Archives of Internal Medicine (link). And for those women using selective serotonin reuptake inhibitors, the chance of stroke, particularly hemorrhagic stroke, also rises.

The study examined data from 136,293 women, ages 50 to 79, who were enrolled in the Women's Health Initiative. The women were followed for an average of six years.

Researchers compared data on women taking an SSRI or a tricyclic antidepressant at their first follow-up visit with data on women who were not using the medication.

There was no difference in coronary heart disease between the two groups. But the women using SSRI had a 45% increased relative risk of incident stroke and a 32% greater risk of death than those not taking antidepressants. The risk of death was similarly elevated among women using a tricyclic antidepressant.